Prevalence and comorbidity of major internalizing and externalizing problems among adolescents and adults presenting to substance abuse treatment

The authors compared the effectiveness of the Seeking Safety group, cognitive-behavioral treatment for substance use disorder and posttraumatic stress disorder (PTSD), to an active comparison health education group (Women's Health Education [WHE]) within the National Institute on Drug Abuse's Clinical Trials Network. The authors randomized 353 women to receive 12 sessions of Seeking Safety (M = 6.2 sessions) or WHE (M = 6.0 sessions) with follow-up assessment 1 week and 3, 6, and 12 months posttreatment. Primary outcomes were the Clinician Administered PTSD Scale (CAPS), the PTSD Symptom Scale-Self Report (PSS-SR), and a substance use inventory (self-reported abstinence and percentage of days of use over 7 days). Intention-to-treat analysis showed large, clinically significant reductions in CAPS and PSS-SR symptoms (d = 1.94 and 1.12, respectively) but no reliable difference between conditions. Substance use outcomes were not significantly different over time between the two treatments and at follow-up showed no significant change from baseline. Study results do not favor Seeking Safety over WHE as an adjunct to substance use disorder treatment for women with PTSD and reflect considerable opportunity to improve clinical outcomes in community-based treatments for these co-occurring conditions.

/pdf/multisite-randomized-trial-of-behavioral-interventions-for-4tizs6t6bi.pdf

Multisite randomized trial of behavioral interventions for women with co-occurring PTSD and substance use disorders.

https://sites.bu.edu/sswhrsaseminar/files/2013/09/Treatment-of-substance-abusing-patients-with-comorbid-psychiatric-disorders.pdf

Treatment of Substance Abusing Patients with Comorbid Psychiatric Disorders

Glutamatergic dysfunction in schizophrenia: From basic neuroscience to clinical psychopharmacology

Behavioral and neurochemical interactions between Group 1 mGluR antagonists and ethanol: potential insight into their anti-addictive properties.

Persons experiencing pain, whether acute or chronic, seek and deserve relief from their discomfort and loss of function. However, opioid analgesics have the capacity to induce tolerance, physical d...

https://www.dentopedia.info/wp-content/uploads/2015/11/substance_use_abuse.pdf

Addiction and the Treatment of Pain

At present, exciting new pharmacotherapies and psychotherapeutic treatment options are being evaluated for their usefulness in adult substance-users with ADHD. Until recently, clinicians and researchers have disagreed as to whether the adult syndrome was even a valid disorder. Therefore, the issues of establishing a valid and reliable diagnosis of ADHD in adults remain largely unresolved. Adults with substance use disorders add another level of complexity when distinguishing core ADHD symptoms from the short and long-term effects of substance use (e.g., attention problems, impatience). In assessing a child for ADHD symptoms, child psychiatrists often seek information from a teacher or parent; however, these sources of information often are not available during assessment of the adult patient. Even when an older family member, preferably a parent, is available, the reliability of the information may be questionable especially if the family member also has a substance use disorder or other psychiatric co-morbidity that affects his or her ability to recall the patient’s childhood behavior. Often times, the lack of fulfillment of academic and/or vocational potential and poor peer relationships can help identify those who may suffer from ADHD. This finding does not offer any more specificity in identifying ADHD in those with substance use disorders given the high likelihood that those with chronic substance use disorders may also have similar academic, vocational, and social outcomes. In order to establish the co-morbidity between these two psychiatric disorders, the best course of action would be provide 1) a method of accurate description of the clinical manifestation of co-morbidity of ADHD and substance use disorders, 2) provide data regarding the etiology of the co-morbid diagnoses, and 3) document the course of illness of the disorder(s) and treatment response.

The most critical contemporary unresolved issues associated with the pharmacotherapy treatment of substance users

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Addiction and the Treatment of Pain

The most critical contemporary unresolved issues associated with the pharmacotherapy treatment of substance users